Hey, What’s it like to be a Paramedic?
I am sure that most of you have heard that question 1 or 200 times throughout your career. It is a topic of interest to the people around you and at the holiday parties that you may be attending this time of year.
Note: I use “Paramedic” as a general term to mean EMT, Firefighter, and/or First-Responder because the general public doesn’t know the difference, usually.
Every Paramedic has an emotion attached to that question. With some, it triggers their depression. In some, it sets their mind on a journey of every horrible call they have been to their entire career. Some get defensive because they feel like they are being scrutinized. Some get excited and are more than willing to tell people what they do and sugar coat the bad parts, so the sweater vest wearing guests don’t reel back in horror. Everyone has their own response to the question but the core of what they tell people is about the same.
When people ask me that, I have just about every emotion listed above depending on the situation. The last few years, I have gotten a bit evasive because it has proven, in the past, not to be the question that they really want to ask. I try to get them off of the subject as quickly as possible with a quick “it’s a great job, you meet a lot of interesting people or it’s a different thing every day and that’s super duper” type answer. The entire time I am trying to deflect them, I am thinking ” you don’t want to open this Pandoras box” or “please don’t make me think about that stuff right now, I am having a decent time” but I try to wrap it up and ask them what’s up in their life. It’s worth sitting for the next 20 minutes while they talk about how little Johny did in soccer or how Amanda did in gymnastics. Your kids are awesome (sarcasm). I love my kids (not sarcasm); even more so now that they are becoming adults and are out in the world. By the way, your boy looks like the dead kid I drug out of a 1995 Cavalier back in ’99. I love parties!
Anyway, the person asking the question doesn’t want to know what it is like to BE a Paramedic; they want to know what is the most horrible thing, the second most horrible thing and the top 10 ways you have seen people die as a Paramedic. They want a sample of what you have rattling around in your brain. They watch Chicago Fire and Nightwatch and assume that what they see is the real deal. I will give credit to Nightwatch, at least it is following crews on the street and attempting to show what it is like to be a street medic. I don’t have that many patches on my shirt, and I don’t call every patient “babe” or “Hun”, but it is a decent representation of our job. It is primetime TV however, so the rough stuff is blurred out. We are not lucky enough to
be able to blur that stuff out of our memory.
I have seen several articles and blogs about the subject of this question and I find the responses interesting. They range from the conversation almost ending in a fist fight to the story teller breaking down into a puddle of their own tears, leaving the minivan driving guests trying to figure out why someone would do that kind of work for that kind of money and why that person was invited to the party. Your tears don’t go well with my Chardonnay and the guacamole dip. Whatever the result, we are the ones who are left at the end of the night feeling drained and violated mentally. The act of asking that question is the preface to emotional turmoil for the Paramedic. It is a scary place so answer the question at your own risk.
So what do I think about when that question is asked to me? Well, it immediately fires up synapses that are usually dormant, and it begins the roller coaster of emotion that I usually bury in alcohol before the night is over. If there is no alcohol, I probably would have left the party before the question is asked. Anyway, I usually ask some “safety questions” to the group that is congregated around. Like “do you really want to know” or “you don’t want some of this in your head so are you really that interested”? That is usually my subtle way of telling them that whatever your nightmares are tonight are not my fault.
Side note: I don’t want to give the impression that I work the party circuit during the holidays. I very rarely go to parties (the whole introvert thing), and I stay pretty quiet when I do end up at one. I get asked that question at various time throughout the year, but it comes up more for all of us this time of year.
So off we go on our emotional journey. I gauge what stories I am going to tell by the crowd that has formed. If they are people that know me pretty well, I talk about some of the more horrible stuff. If they are strangers, I keep it PG-13ish and leave out some morbid details. Some stuff that we see is impossible to explain to regular people because the only way it makes any sense is to see it first hand and absorb everything that led up to what you are looking at. We digest the information on scene and put it in our brain vault for later. I don’t try to give them a warm and fuzzy feeling about being a Paramedic because it is not warm and fuzzy (most of the time). I am honest and try to make them understand what the healthcare system looks like from the pre-hospital point of view. I try to give them insight on how a Paramedic fits in the overall scope of the system and how what we do affects the clinical course of our patients on down the line. I use the analogy that day or night, you have to go to a place you have probably never been before, talk to someone you have probably never met and decide whether they have a general math question, a story problem or a calculus equation for you to solve and you only have 5-10 minutes to solve it because you will be at the hospital ED in that amount of time. That doesn’t hold their attention for long because lets face it, they are all voyeurs. They want to peer into the dark parts of the job because, deep down, they are excited by stories of the suffering of other people. At least the ones they think are below them in social standing. They don’t realize that they are only one drift across the center line of being that ground beef in the drivers seat. That they are one Oxycontin away from being that unresponsive on the living room floor next to their daughter’s power wheels pink Jeep. That they are that one misplaced candle away from needing to be drug out of the inferno. That they are one cheeseburger away from being that coworker that their office pals had to do CPR on before I get there. They don’t realize that they could be that person that is minding their own business and gets hit with a stray round from the gun fight one street over. They don’t think that they may be a few failed life events away from being that
homeless junkie I had to revive. They don’t realize, and I am jealous sometimes that they get to go through their day without thinking about those kinds of things or not remembering a call you had six years ago and thinking if I had just done that one thing, that person may still be alive today.
So I lay it out for them if they can take it. I talk about working full arrests on people that are younger than them and that those people don’t spring back to life after I shock them then hug me as we sing “don’t stop believin’”. I talk about how I had to lay in mud so that I could talk to the 19-year-old kid that is in an upside down car with the brake pedal jammed through his leg and his dead friends head stuck under the seat from the impact. I talk about how I went to a full arrest at a nursing home to find a guy my age who has been down for 10 minutes before they even called, cool to the touch in the extremities, has cancer and had refused hospice care and have to ask the lead Paramedic “what are we doing with this because someone needs to make a decision”. I tell them about handling 4 or 5 overdoses in the same shift and giving Narcan to the same person twice in 12 hours. I tell them about doing CPR on a 90-year-old woman and feeling all of her ribs break with CPR while her husband of 50 years stands next to me and asks if I need any water or if he needs to take a turn at compressions. I tell them about the time I went on a call to find one of my dad’s best friends crushed under a piece of farm equipment and having my dad ask me every day for a week what happened and how his friend looked when I got there and had to say to my dad “you let me keep that picture in my head. You don’t want it. You just remember him how he was”. They are on the edge of their seats and hungry for more, like waiting for the next action scene in a movie. I give them a lot, but I know when I have had enough, so I switch gears.
I start talking about the people that stop us when we are out getting food to say thank you for our service or pay for our meals. I tell them about the frail old lady who apologizes 30 times for calling me in the middle of the night to take her to the hospital because she is at the end of a very long road and knows that she probably won’t make it out of the hospital this time but wants something to ease the pain. I tell them about how awesome the shift was when I got to sleep all night. I talk about reading to the kids at the elementary school and talking to community groups about fire safety. I talk to them about the fun and frustration of mentoring new Paramedics and new employees. I talk to them about how we support each other when that horrible call kicks us all in the st
omach. It gets emotional, but I use my 20 plus years of cramming my emotions down my spine and keep the conversation lively.
So we all have to deal with that question at one time or another. It brings out emotions in all of us that hang on for hours or days at a time. As I said in the last post, we all have different career paths. I may have seen more than the guy on my left but not as much as the girl on my right. They have been through what they have been through, and I have been through what I have been through. It affects us each a different way. Your answer to the question will be different than mine. That’s the way it is.
What will you have to say when they ask you? I would suggest that you be honest. If you get emotional, let them see that to. It may help them understand that the job you do is not like working on an assembly line or delivering the mail. Your job is woven into who you are and, in time, is wired directly into your heart and brain. That talking about it sometimes helps us to heal some of the wounds that we have acquired over the years of our career. Know when to say when. You need to know when you are done talking about it.
My answer to the question has changed over the years. The one constant is my ruthless attempts to freak my mother out about the situations I get into. I like to hear my mom say “I’m glad you are safe.” It never gets old.
What will your answer be?
I’ve been asked that question over the years, but have never had the flood of emotions described here. I do gauge my stories to the audience, but I’m happy with my career and the choices I’ve made over the years even though I’ve seen the worst humanity has to offer. I know that things generally got better for my effort and, at worst, stayed the same as they would have been had we not shown up. I take comfort knowing that we didn’t cause the fire/injury/illness, but most likely mitigated the issue, at least in part. I can understand feeling empathy for the people we serve, but if recounting their story brings out emotions that last for days I would encourage seeking help. Family, coworkers and citizens rely on us to be in control of our emotions.